ACT Health Direction: What It Is and How to Make One

A Health Direction is the ACT's statutory instrument for refusing medical treatment — and it is significantly narrower than what most people expect when they hear "advance directive."

What a Health Direction Can and Cannot Do

Under the Medical Treatment (Health Directions) Act 2006, a Health Direction is legally binding on clinicians, but only for one purpose: refusing or withdrawing specific medical treatments. You can direct doctors to withhold CPR, turn off mechanical ventilation, or decline artificial feeding and hydration.

What you cannot do with a Health Direction is consent to future treatments in advance. If you want to request a particular intervention — say, aggressive cancer treatment or a specific palliative protocol — those instructions carry no legal weight under this Act. They become guidance for your substitute decision-maker, not binding clinical orders.

This is a narrower scope than advance directives in most other Australian jurisdictions. In South Australia, for example, the Advance Care Directives Act 2013 allows both binding refusals and binding consents. In the ACT, positive treatment requests belong in your Statement of Choices (non-binding) or are left to your EPoA attorney's discretion.

The Approved Forms

The current approved form is Form AF2017-46, available on the ACT Legislation Register. A Health Direction can be made in writing, orally, or in another way. A non-written direction must be witnessed by two health professionals, one of whom is a doctor; a written direction is far more reliable in practice and carries less risk of being disputed or forgotten.

Witnessing Requirements

A written Health Direction needs two adult witnesses who both sign in the presence of each other and the principal. Unlike an EPoA, there is no requirement for one witness to be a prescribed professional (such as a solicitor or JP). Any two adults can witness a Health Direction; the Act does not impose the EPoA's attorney-witness exclusion.

The principal must have decision-making capacity at the time of signing. If capacity is later lost, the direction remains legally valid and binding.

The Chronological Hierarchy Trap

This catches many families. Under section 19 of the Act, if a Health Direction and an EPoA for healthcare or medical research matters are consistent, the attorney must comply with the Health Direction. If they are inconsistent, the attorney must comply with the EPoA when the Health Direction was made first, and with the Health Direction when the Health Direction was made after the EPoA.

The safe execution order, when you want a later Health Direction to control an inconsistent treatment decision, is: sign the EPoA first, then sign the Health Direction. Make the wording consistent wherever possible.

What Clinicians Must Do When They Receive One

When a treating health professional becomes aware that a patient has a written Health Direction, they are legally required to comply with it if they reasonably believe it complies with the Act and has not been revoked or changed. They must withhold or withdraw the specified treatment, even if they personally disagree with the decision.

There are limited exceptions. A Health Direction does not override the duty to provide palliative care and pain relief — comfort measures continue regardless. If the direction is ambiguous or its validity is questioned (for instance, there are doubts about whether the principal had capacity when signing), the clinician must not withhold or withdraw treatment unless they reasonably believe the direction complies with the Act and has not been revoked or changed. For an inconsistency between a Health Direction and EPoA, an attorney can apply to the ACT Civil and Administrative Tribunal for a declaration under section 19.

The practical challenge is making sure the document reaches the right clinicians before it matters. Uploading a certified copy to the MyDHR patient portal through Canberra Health Services ensures it is flagged in the clinical system. You can also upload it to your national My Health Record for visibility across state borders.

The ACT Advance Directive & Living Will Kit includes a storage and distribution tracker that maps every copy to its destination — GP, hospital system, attorneys, and family members — so nothing falls through the cracks during a crisis.

See more Australian Capital Territory guides →